Date of Award
Doctor of Philosophy
Naima Moustaid Moussa, Michael Zemel, Charles L. Thompson
This study investigated the effects of dietitian weight status, dietitian self-disclosure about personal weight issues, and participant weight status on participants' initial perceptions and evaluations of registered dietitians. The research design was a randomized 2x2x2 factorial design consisting of 2 dietitian weight status conditions (normal weight and obese), 2 dietitian self-disclosure conditions (absence or presence of self-disclosure about personal weight issues), and 2 participant weight status conditions (normal weight and obese). A simulated nutrition counseling situation was developed in which participants were shown a photograph of a dietitian and then listened to an audio recording of an overview of nutrition counseling supposedly prepared by the dietitian. Participants were subsequently asked to evaluate the dietitian on a variety of dimensions related to nutrition counseling. Results of this study were divided into 3 parts.
In the first part, the outcome measures were participants' ratings of the dietitian's expertness, trustworthiness, and attractiveness, as measured by the Counselor Rating Form. Statistical analyses included multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA) as appropriate. Results indicated that an obese dietitian who self-disclosed about (i.e., verbally acknowledged) her current overweight status was rated as less expert (p = .0003) and attractive (p = .02) by normal weight participants than an obese dietitian who did not self-disclose. These effects were not observed with obese participants.
In the second part, the outcome measures were participants' ratings of their willingness to begin nutrition counseling with the dietitian, perception of the dietitian's knowledgeability, perception of the dietitian's effectiveness (both general effectiveness and effectiveness within a variety of specific nutrition counseling contexts), perception of the dietitian's status as a role model, comfort in discussing personal concerns with the dietitian, and perception of the dietitian's ability to relate to their concerns. Analyses again consisted of MANOVA and ANOVA as appropriate.
Results indicated that participants were less willing to begin nutrition counseling with the obese dietitian compared with the normal weight dietitian (p = .01). No effects were observed for participants' ratings of the dietitian's knowledgeability or overall effectiveness as a nutrition counselor. However, the obese dietitian was generally perceived as less effective than the normal weight dietitian in "weight-related" nutrition counseling contexts (p ≤ .05). The normal weight dietitian who disclosed a past history of overweight was seen as a better role model than the normal weight dietitian who did not self-disclose (p = .02). The obese dietitian who acknowledged her current overweight status was seen as a poorer role model than one who did not self-disclose (p = .0007). Normal weight participants were more comfortable with the normal weight dietitian than with the obese dietitian (p = .01) and also thought that the normal weight dietitian would be better able to relate to their concerns (p = .005). Obese participants were equally comfortable with the normal weight or obese dietitian, but thought that the obese dietitian would be better able to relate to their concerns (p = .009).
In the third part, the outcome measures were again participants' ratings of the dietitian's expertness, trustworthiness, and attractiveness, as measured by the Counselor Rating Form. For this part, predictive models were developed for each of these dependent variables using multiple regression procedures with stepwise selection method. Potential predictors in each model were participants' internal, powerful others, and chance health locus of control beliefs, as assessed with the Multidimensional Health Locus of Control (MHLC) Scale. Results indicated that participants' powerful others health locus of control scores were positively related to their evaluations of the dietitian's expertness, trustworthiness, and attractiveness (p ≤ .05 in each model), while their chance health locus of control scores were negatively related to their evaluations (p ≤ .05 in each model), These health locus of control dimensions accounted for small, but significant amounts of variability in each dependent variable (model R2 values of .05 - .07).
Some overall conclusions may be drawn from the results of this study. First, in no instance was it beneficial for the obese dietitian to verbally acknowledge her current overweight status; acknowledgement of personal overweight consistently resulted in more negative perceptions of the dietitian by participants. Negative effects of dietitian obesity were observed for some of the outcome variables; most notable was that participants were less willing to begin nutrition counseling with the obese dietitian. Otherwise, when dietitian weight status was important in participants' perceptions, the effects appeared to be context-specific and/or dependent upon the weight status of the participants. Thus, in some situations, obese dietitians may face an additional barrier with clients that normal weight dietitians do not face. Finally, a characteristic of the participants, health locus of control orientation, also played an important role in their perceptions of the dietitian. In conclusion, characteristics and behaviors of the dietitians, as well as characteristics of the participants, were important factors in participants' perceptions and evaluations of registered dietitians.
Bounds, Wendy Elizabeth, "The Effects of Dietitian Weight and Self-Disclosure About Weight on Women's Evaluations of Registered Dietitians. " PhD diss., University of Tennessee, 2002.